travel CRNA

January 2019 update

I haven’t been writing or “vlog” -ing lately.  I think it’s important to occasionally update you on the site.  Where we are and are headed can help you see the new information and point to available resources.  

we had a conversation with Bonnie about her career as a locum CRNA via Skype which was transferred to YouTube.  She comes across quiet due to recording via Skype.  In the future we’ll go back to zoom as it records better. I had a couple other recordings but CRNAs decided they would prefer not to post.  Conversations don’t have to be 45 minutes or longer!  Even a recorded question or two would be great, if you want to post for the benefit of the group!  

We are adding to the site many of the resources that are part of the site.  The Amazon Store has added books and common travel needs for CRNAs.   

We added a financial advisor with MassMutual who was at the VANA conference and have asked about some guest posts for our blog.   

On the site we added CRNA owned companies that are not just CEU or recruiting agencies.  Recruiters can post on the job board that is relatively new on both sites and CEU companies (all CRNA owned) have there own static page always available to you!   


I need people willing to discuss on the YouTube channel.  

I need to update the CEU listing for current programs. 

i need to finish all state boards of nursing and CRNA licensure requirements, all state boards are linked to their respective website but I haven’t completed listing their individual requirements.   

I’d love to get more of the CRNA owned companies on the website and maybe list by state.  I think many would be reps like R&F and I think if that’s the case we can put a primary post for the company then each individual that sells.... I can’t have 100 R&F companies as many would quit looking after one scroll.   

I, also, would love to get more information on helpful static pages.  I am going to work on one for student loans as this is always a re-post on the sites, otherwise I need to know what would be most helpful for you?  

Thats your update for January 2019!  Email me at if you have suggestions or want to help-out! 


Investments without large fees

Investing is not one of our best endeavors and many just don’t take the time to learn. With only a few minutes left in the year, here is some information you might not want to miss.  

I was just listening to the ChooseFI podcast and found out a few things to pass along.  First, I recommend listening to them as you journey through life whether you are planning to retire early or not.  

HSAs or Health Savings accounts for any high deductible insurance plan that is define as 1350 for an individual or 2700 for a family.   You can put away 3450 individual or 6900 for a family in an HSA TAX FREE.   Any medical expenses can be taken out TAX FREE at any time / any year!  This of course means you have to keep your receipts for your accountant for years.  After age 65, it acts like a traditional IRA or can be used for medical expenses later in life.  If your plan started dec 1 you could find the entire amount.  Fidelity now has a zero fee HSA management account (funds or investments places in the account may have some fees).  

This is way different than an FSA as those funds don’t fully roll-over year to year.   these funds are for your yearly medical expenses and are typically use or lose.

We are typically interested in low fees and trying to keep our income in our pockets.  Mutual fund investments are just about the most common across the nation and ChooseFI often touts the Vanguard total stock index fund or VTSAX which had a hefty $10k minimum which has now changed to a $3k minimum for getting started.  This opens the fund up to those who are wanting to get started investing at one of the lowest fee mutual funds on the market at an annual fee of just 0.04%! 

Some of you may know these things but the mutual fund information is pretty new.  If you are thinking of setting up the Solo401k it has to be done and funded by the end of the year and if you are looking at a sep IRA it must be done and funded by April 15.   

It’s time to get your investment on! 

Is it difficult to set-up a sep-IRA?

I have been a CRNA for quite some time, as you might be aware.  I have tended to keep my earnings and retirement away from the stock market.  As many would chastise me for not taking advantage of tax sheltering, and even I wish I were a better saver.  

I have always invested in real estate.  For a while it was my own home.  Then it was the start of rental property in Kansas.  I am still invested in Kansas and started on my current home in Virginia.  

I have avoided the stock market though.  I have used an E-Trade account as if it were a casino.  I haven’t been an investor but a speculator.  I have invested over the years in the military Thrift Savings Plan ... 1% for 9 years... you know how little that is.  I forget to take time to learn about those things.  I know I need to shelter my taxable income so I am actually doing this.  

I went for weeks totge website for Vanguard but then they said they couldn’t verify me.  Then I had to fax things for the Solo 401K but... I missed 2017.  So, I decided I would do a simple Sep-IRA if I could.   

I was checking my E*TRADE to make sure my Roth IRA transaction went through and then I had an epiphany.  Why not try to set up just an IRA.  I saw the set-up a retirement account button and so I clicked on it.  Bam, Sep-IRA option right there.  Two minutes later i had $6k coming out of my account to fund a Sep-IRA for 2017.  I have until my taxes are filed toget those dollars cought up. I would prefer a Solo-401k but I didn’t get it set-up in 2017 which means no $$$ can beplaced in it for 2017.  So, i now have a sep and I’m working on saving a tax bracket or two by saving more pre-tax dollars toward retirement as my rentals are post tax.

Is it possible to invest in retirement with real estate?  Yes, but have I done this... no.   

Every year, I will try to be more active in my tax planning and save betterfor my family and child or children (someday).   



it’s always interesting going new places.  I love it.  I have fun and treat people as if I’ve known them for years.  I have fun at work while getting the serious things done in a quick and efficient manner.  I believe that this relaxes the crew and the patient.  I always state that I’m not new to anesthesia but am new to the facility and why I’m going through the paperwork a little more. 

I expect to be checked on a little more or observed more closely if in a “Care team”  model.  CRNA group the same happens just because they don’t know me or what I do/don’t know.  It’s just how things go.  I also expect them to vary the assignments from big to little to tiny and see how they wish to utilize my skill-set... it’s a way of interviewing me.  They see if I complain or fumble or have issue with those that have the most awesome personality.  These things are part of the locum political environment. I generally say that I stay out of the politics by being a locum.  I should have been saying that I remain outside of the political arena that most ACT CRNAs are in.  It’s not that it doesn’t exist ... it’s just significantly less than full-time staff typically experience.  

I have some docs and CRNAs that try to teach me at times ... from how I should hold my Miller to doing a CVP fall whenever doing a central line.  I’m not above learning and I’ll simply nod or oblige if they want something simple that’ll re-assure them that my intervention is done safely and efficiently.   

I guess what I’m saying is that each place I go I expect a period of assessment in some way.  I expect to be thrown in to the mix quickly and handed around to the different personalities and surgeons.  I always listen too.  When I hear “oh, they put him there...” I know it’ll be an interesting day.  I think we, as locum providers, need to know whom the client is, how to handle interpersonal communications, and have to be more knowledgeable in a broader scope of practice than most institutions utilize.   

I think it takes about 4-6 weeks for a place to get used to a new provider whether it be locum or permanent... then 5-9 months to understand how a place operates and if they are a good provider fit.

These are just my thoughts on the day. 


Write off or included in your contract?

Here are a few things I didn’t think about when negotiating my next two weeks.  

1.  How am I getting to the airport?  I typically drive to every assignment so when it came to the airport I didn’t think about ... Will I Uber there?  Do I leave my car in airport parking?  Do I assume my husband will take me?  Ok the later is typically true but, now he is sick and didn’t want to take me.  I have$7 in tolls just to get that trip to the airport.  

2.  When I get the rental car in Massachusetts will they pay the tolls to and from the airport?  It’s not in my contract per say.   

3. I have clothes for a week but they don’t have baggage as an expense for taking the flight so now I don’t have enough to wear for two weeks without doing laundry.  Has anyone been reimbursed for laundry?  I also can’t take fluids or razors so no toothpaste, shaving cream, razor.... that stuff can be expensive right?  

4.  It’s a travel day before my assignment starts ... a day with no family and a day that i can’t work.  Non-productive and a loss of income.  Does anyone get paid a travel day on either end?  Usually if I drive ... I at least get travel expenses.   

These are a few things we might look at for future travel contracts.  does everyone consider these written off expenses or do you get them paid out so you get to save the expense in the first place?

Five Ways CRNAs Can Minimize Their Tax Burden

Five Ways CRNAs Can Minimize Their Tax Burden

by Jeremy L. Stanley, CFP®, AIF®

One of the great things about being a CRNA is the lucrative salary. What’s not so great are the high taxes that accompany it. A 2015 Gallup poll showed that 63% of Americans are dissatisfied with the amount they pay in taxes, and many CRNAs fall into this category1. With an average salary of $160,2502, CRNAs can pay between 28% and 35% just in federal taxes (depending on their filing status and spouse’s income)3. On top of that, CRNAs receiving a W-2 face limited tax deduction options, as they often can’t take advantage of deductions for business, travel, and other expenses.

Beyond income taxes, many CRNAs are bumping up against the Alternative Minimum Tax (AMT). The AMT is a supplemental income tax required in addition to the baseline income tax for select taxpayers who have deductions and exemptions that allow for lower payments of standard income tax. This means that some taxpayers must calculate their liability twice (first under income tax rules and second under AMT rules) then pay the higher amount. While this tax was initially designed to keep wealthy taxpayers from using loopholes to avoid paying taxes, it now impacts more than 5 million filers. The AMT exemption is similar to the standard deduction for calculating your alternative minimum tax. For single taxpayers, the 2017 exemption amounts start at $54,300 and phase out at $120,700, and for married couples filing jointly, the amounts range between $84,500 and $160,900.4

Working with a tax professional throughout the year can help you legally minimize your overall tax liability and chances for owing the AMT, including CRNAs who receive a W-2. Here are a few strategies for minimizing your taxes.

Understanding W-2 versus 1099 Tax Planning

Before diving into tax strategies, it’s essential for CRNAs to understand the differences between W-2 tax planning and 1099 tax planning.

As a CRNA receiving a 1099, whether full or part-time, you can take tax deductions that a W-2 employee cannot take, including deductions for travel expenses, insurance, office and medical supplies, and other business-related expenses (as well as saving significantly more money each year in tax-advantaged retirement accounts). Depending on your job status and goals, you may consider working as a business owner or freelancer and using a 1099, which gives a wider array of options for tax deductions. A tax professional may also help you take advantage of deductions you weren’t aware you were eligible for.

Use the Correct Filing Status

Your filing status determines your filing requirements, standard deduction amount, eligibility for a variety of tax deductions, and the amount of tax owed annually. When it comes time to file, make sure you determine which filing status is most appropriate for you.

Currently, there are five IRS filing statuses:

  1. Single

  2. Married filing Jointly

  3. Married filing Separately

  4. Head of Household

  5. Qualifying Widow with Dependent Child(ren).

It is important that you select the correct filing status for your given situation. The IRS provides a few basic tips to help you determine which filing status is most appropriate for you:

  • Your status on the last day of the year determines your status for the entire year. For example, if you were married on December 27th, even though you spent the majority of the year working as a single professional, you must file your return as married.

  • If your spouse died during the tax year, and you didn’t remarry, you may choose to file a joint return for that respective tax year.

  • Married couples can choose to file separate returns, but depending upon their state of residence, a financial benefit may not result.

  • The term ‘head of household’ applies to filers who are not currently married. In order to claim this filing status, the individual must be financially responsible for at least 50% of all costs resulting from maintaining a household, including those costs of another qualifying person.

If more than one of the available filing statuses is applicable, choose the one that results in the least amount of tax owed.5

Use Tax-Favored Retirement Accounts

If you are an employee of a hospital, you may not have as much room to strategize regarding your tax-favored retirement savings. However, if you are a freelancer or business owner, you can employ a variety of strategies to lower your total tax bill. As highly compensated professionals, pre-tax contributions into qualified retirement plans can reduce your adjusted gross income. The most common employer-provided qualified plans are 401(k) and 403(b) plans.

As of 2017, CRNA employees with a 401(k) or 403(b) can defer up to $18,000 of their annual earned income on a pre-tax or after-tax basis. Participants over the age of 50 can also take advantage of the catch-up provision and contribute an additional $6,000 (These amounts can change annually).6

One of the many benefits of being a business owner or freelancer is that you can lower your total taxable income even further. Solo 401(k)s and SEP IRAs are the two primary qualified plan types available. With a SEP IRA, you as an ‘employer’ can contribute up to 25% of your compensation or up to $54,000.7 For solo 401(k)s, the annual employee contribution limit is the same as the traditional 401(k) plan ($18,000 for the 2017 tax year, or $24,000 for those over the age of 50). In addition, ‘your company’ can also contribute a profit sharing contribution of up to 25% of your income allowing total combined contributions to the plan of up to $54,000 (or $60,000 including the catch-up contribution if you’re over the age of 50).6 Some solo 401(k) plans also offer a Roth provision which will allow you to designate some of your elective salary deferrals as Roth contributions. This means that you can put post-tax dollars into a retirement plan which will grow (including the earnings) generally tax free.8 Because of their high salaries, many CRNAs are not eligible to contribute to a traditional Roth IRA, so this may be a good option to diversify funds for retirement.9

Search for Eligible Tax Deductions

The amount you are taxed is based on your taxable income. The lower your taxable income, the less you’re taxed. Tax deductions can help you reduce your taxable income; two-thirds of all tax returns use the standard deduction because many taxpayers aren’t familiar with this strategy.10 Don’t overpay your taxes by not taking full advantage of available tax deductions. You may be eligible to take advantage of one or more of the following tax credits, exemptions or deductions:

  • Earned Income Tax Credit: For CRNA employees who earned less than $49,078 from wages or self-employment, a tax credit up to $5,751 may be available.

  • Child and Dependent Care Tax Credit: If you have paid ongoing expenses for the care of qualifying children under age 13, a disabled spouse or other dependent, including a parent, you may be eligible to take advantage of this credit.

  • Child Tax Credit: If you have qualifying children, depending on your income, you may be eligible to take a deduction up to $1,000 per child in addition to the above mentioned child care credit.

  • Education Credits: These education credits are available to help offset higher education costs for yourself or eligible dependents. There are two primary education credits currently available, which include:

    • Lifetime Learning Credit: Up to 20% of the tuition costs, limited to $10,000 of expenses, may be deducted for each eligible student for higher education expenses such as tuition, fees and books required to complete courses. The credit is eligible for married couples filing a joint return with a modified adjusted gross income of $120,000 or less.

    • The American Opportunity Credit: Up to $2,500 per eligible student may be deducted for up to 4 years of postsecondary education. Each eligible student must be pursuing either an undergraduate degree or approved credential. Full credit is available to married couples filing a joint return with a modified adjusted gross income of $160,000 or less.

  • Sales Tax Deduction: While this tax offers benefits for all U.S. residents, it offers the greatest benefit for residents of states not currently imposing state taxes. Why? Filers can deduct the greater of their state and local income taxes or state and local sales taxes. If you completed large retail purchases within the most recent tax year (car, boat, furniture, etc.), then this deduction could result in significant federal income tax savings. Additionally, if you live in a state with income tax, the sales tax deduction can limit the federal tax-ability of your state refund.

  • Real Estate Deductions. If you own a home, you can deduct expenses by itemizing deductions on a Schedule A. You may be eligible to deduct mortgage interest on up to two properties as well as real estate taxes all properties, if not listed elsewhere on your return. Note, mortgage interest in excess of $1 million in acquisition debt, or for home equity debt that is not used to buy, build or improve your main home is subject to AMT calculations.

  • Rental Property Deductions & Income. Keep track of rental property deductions on a regular basis. If you or your spouse are a qualified real estate professional, you may be able to include potential losses on your annual tax return.

Other common tax deductions CRNAs may be eligible for include:

  • Interest paid on a first mortgage for your main home, as well as a second home for up to $1 million in loans.

  • Interest paid on second mortgages or home equity loans for your main home, as well as a second home for up to $100,000 in loans.

  • Interest paid on student loans (depending on whether or not your income is within allowable limits-many CRNAs may not qualify).

  • Investment losses.

  • Medical expenses (including health insurance premiums)

  • Professional fees exceeding 2% of your adjusted gross income (e.g. investment, financial planning, accounting, and some legal fees).

Deduct Eligible Charitable Contributions

Annual gifts to qualified charitable organizations may be deemed an eligible itemized deduction. Each gift must be noted on Schedule A of your 1040. If your annual non-cash gifts are in excess of $500, you must also complete IRS form 8283, which must be attached to your completed return. If you received benefits as a result of your charitable donation, only the amount in excess of the benefit received may be deducted. Non-cash property as well as investment donations can be deducted at their fair market value. If you donate clothing or other household items, consider using available online value calculators to determine the total value of your contribution, saving these records in the event of a tax audit. Records for all donations must be maintained, including bank records, payroll deduction notices, charitable donation receipts from the qualified organization, or phone records for text message donations.

Deduct Eligible Business Expenses

There are a number of benefits of being a 1099 CRNA (or business owner), and one of those is
tax deduction availability. Business owners, freelancers, and sole practitioners may be eligible
to deduct qualified business expenses on their annual tax returns. In order to qualify for these
business expenses as an employee, you must be itemizing using Schedule A.
Along with business owners, CRNAs working in traditional hospital settings may be eligible to
deduct the following non-reimbursed business expenses:
● Business travel (airline tickets, car rentals, taxi cab fees, business meals and
● Use of your vehicle for business purposes
● Business meals and entertainment (Be sure to note who you dined with, how long it
lasted and what was discussed on the receipt for verification purposes when it comes
time to claim the deduction)
● Continuing education (particularly that which is required to maintain professional
licensing requirements)
● Supplies and tools required for your position
In order to deduct qualified business expenses, you must maintain records to serve as proof
(bank statements, receipts, mileage logs), and the expenses claimed on your tax return must
not be part of a reimbursement plan at work.
In addition to taking advantage of each of the credits and exemptions, be sure to spend a few
minutes annually reviewing your tax withholding status. If you receive either a sizable tax bill or
refund annually, it may be wise to adjust your paycheck’s withholdings. If you owe, you need to
increase the amount taken from your paycheck in order to balance out your payments. If you
receive a refund, you are essentially providing the government with an interest free loan by
providing your hard earned capital over the course of the tax year. Instead, adjust your
withholdings so that you receive these funds over the course of the year. Additional
discretionary cash flow can be utilized for a variety of purposes, including debt repayment, cash
reserve accumulation, or retirement investments.
Business owners may also be eligible to establish material participation for tax purposes. In
terms of income taxes, tax law distinguishes between types of income, including income from
passive investments and active businesses in which a taxpayer “materially participates.” Many
sole proprietors are qualified to claim material participation because they often spend a
significant amount of time handling the day-to- day management of their business.
While there are a myriad of opportunities for reducing your taxes, CRNA business owners and
1099 filers have even more opportunities to minimize their tax liability. However you decide to
invest and plan for your financial future, it’s important to work with both an accountant, as well
as a CERTIFIED FINANCIAL PLANNER™ practitioner who specialize in serving the unique

needs and circumstances of CRNA business owners. CRNA Tax Associates ® specializes in
working with CRNAs to make the most of their earnings and collaborates with CRNA Financial
Planning® to keep your strategies aligned. Do you have questions about how we can help you?
To learn more about CRNA Tax Associates®, visit or to schedule
an appointment, call 336.793.2264 or email

1. federal-taxes- low-side.aspx
3. tax-rates- personal-exemptions- and-standard-

4. amt
5. correct-filing- status
6. participant-employee/retirement- topics-401k-
and-profit- sharing-plan- contribution-limits

7. participant-employee/sep- contribution-limits-
including-grandfathered- sarseps

8. plans-faqs- on-designated- roth-

9. participant-employee/amount- of-roth- ira-
contributions-that- you-can- make-for- 2016


The opinions voiced in this material are for general information only and are not intended to
provide specific advice or recommendations for any individual. This information is not intended
to be a substitute for specific individualized tax advice. We suggest that you discuss your
specific tax issues with a qualified tax advisor.
About Jeremy Stanley
Jeremy Stanley is the founder of CRNA Financial Planning ® as well as CRNA Tax Associates ® .
He has been providing advice and guidance for Certified Registered Nurse Anesthetists
(CRNAs) for over two decades. As a CERTIFIED FINANCIAL PLANNER™, Jeremy has met
rigorous certification and professional standards set by the CFP Board. He is committed to
adhering to the principles of integrity, objectivity, competence, fairness, confidentiality,
professionalism and diligence when dealing with clients.

Jeremy is also the author of The Wealthy CRNA and A CRNA’s Life After Anesthesia. The
Wealthy CRNA features insights into becoming a financially successful CRNA and how to start
planning for your financial future, and has been prior approved for up to 4 Class A CE credits by
the AANA. A CRNA’s Life After Anesthesia serves as your financial roadmap for a smooth
emergence into retirement. It reviews recent changes in the CRNA industry along with the new

rules of retirement and the final steps of legacy planning. This book has been prior approved by
the AANA for up to 2 Class A CE credits.

A little independence

It’s been a great start.  Do you ever get to the point of I’m going to a new place and you are super excited until a little before you actually go?   

After all the excitement dies, the nerves kick in. You wonder why are they having such difficulty? Why am i needed?  What are the surrounding politics and issues? Then it’s a myriad of conjecture that has you just about to say “nope, I’m good to stay home.” Yes, after multiple years i continue to get those pre jitters.  This time was more because it was very temporary and only a couple weeks work.  I need the work but I could just ride the debt wave just a little.  If you don’t know debt and your a Ramsey fan... i sooooo applaud you and I’m jealous.  

Anyways,  I’m here & so happy i didn’t just give in to staying home.  I’m at a GI center with just myself and another CRNA and it’s nice.  Just enough work to pay some bills. Yet, I get home in time to do things and relax.  We even went to find a YMCA to join while we are around the country! (Did you know they have babysitters for two hours a day?!) yes, that last comment makes me sound ... older.   

Today is another day that will be busy with deliveries and paperwork that is all being pushed to Francisco and my parents as I’ll be working!  It’s awesome to be able to say that I’m sorry and have to work. It’s very true as i had more available weeks and they just couldn’t use me.   

I’ve supplemented with work back in Massachusetts for two weeks!  That’ll be somewhat more of a challenge but still fun to see people i worked with in the past.  

I can’t wait to keep you updated on locum life.  this weekend I start making my presentation for Costa Rica! What an adventure the next 6 months will be!

Rough start

We left Philadelphia and things were looking good for the first 30 seconds.... 

We hit rush-hour traffic and were in a losing battle of time and weather.  I drove the blasted uhaul (26 foot beast) straight down as much as I could.  By 8:30pm it was snowing.  I was supposed to be in by 8:55 and I had so far to go.  Francisco became overwhelmed by the night and snow forcing he and Elizabeth to stop about 80 miles from Hampton Roads.  I forged on with the thought that i would not miss closing on the house or work.   

  I woke this morning to the information that the tunnel was closed and snow would last well into the day.  I made e-mails and texts in order to get the closing on the house accomplished.  Finally, i had an Uber to the notary’s home.  I officially closed and Uber said no cars were available.... i walked through the snow in order to get back to the hotel.  We are now the proud owners of a home loan.  

I found out i was cancelled for work on Friday.  Very happy for the 8 hour guaranteed day!   

This potentially gives me time to get things moved into the house!  Many things to be done!   

All those on the New England coast... be careful in snowmageddon.  


i don’t know about you but it’s pretty crazy around our household.  My calendar for January is looking busy. Next week will be a crazy time and my husband might disown me.  

Wednesday, like all days I’ll be up and going to work at 6 AM.  The difference is that the movers will be walking in the door at 6AM.  They are packing everything then loading the Uhaul.  Then, I’ll get home from work and we drop off the keys, fobs, and say see ya later to Philadelphia.  We are to make it 2.5 hours south into Maryland.   

Sounds totally easy right?  We only have to put the dogs up front in the Uhaul.  Get the kid in the back seat of the Jeep and have everything packed/loaded in 10 hours.  The next morning we have to leave by 7AM.  If not we miss the walk-through on the home that has caused some stress over the past weeks.  

We’ll drive another 2.5 hours and arrive immediately at the house.  Park in the driveway walk through the home and make sure all is in good order.  We’ll rush to the hotel and drop off the dogs, check in for my parents and us for the two whole nights.  Then it’s again off to closing in Virginia Beach.  When that part is done we’ll again be home-owners.   

It doesn’t sound like too much.  But, I start work the following day so again it’s up to Francisco to get things unloaded from the Uhaul and unpacked.  my parents are coming to help install, set-up, baby-proof, and shop.  I don’t know if they are ready for what they are in for!

The one-day move and in-between contracts.  It’s going to be a bit stressful but i know we can do it!   

The rest of the month is just surrogacy, 3 work places and contracts, two birthday parties, and having a fence built.  

Planning just like all things is key but being able to maintain the plan as a fluid work is key.  Happy almost New Years! 


I was listening to someone talk in the lounge saying they would never leave this area.  Her husband was offered an amazing opportunity and they said no as it wasn’t in the city.  Their kid was going to college and they begged to have them closer to home and now they think they might return to the same city.   

I guess this idea of staying in one place for life or not entertaining moving for career or home is foreign to me.  I’ve moved around and met new people my whole life.  Freinds of the long term capacity can be hard to come by.  However, within the military life of moving i found lifetime friends.  I know moving has allowed me to make friends around the country and understand different types of people, culture, and demographics. 

I tend to think anyone could do the locum life if they were so inclined but I’m learning that the more rigidly settled a person is the less likely for them to do locums.  Per diem in multiple hospitals in the area might be their perfect gig and while it may be 1099 it is unlikely to be billed as locum.  Others find a w-2 job that will allow them to work 2 full time jobs.  I see them race from call shift to call shift and i wonder how they do it when i know how it feels working 60-80 hour weeks and how lovely it can be at 40 hours.   

I think it all comes down to motivation.  Part of my motivation is to keep up in all areas of practice so I’m well rounded.  My goal is to be flexible, work a fair amount and over.  I want to be capable of going into any room and being comfortable.   I love new sights and allowing family to see all that surrounds us and our opportunities as we grow together.  Others, look for safe, secure, & what is known.  Others look for moving up the ladder of success in leadership, research or business as they grow and that is their motivation.   

Its fun to learn where people are in life.  Then it is nice to remember those people and in going to new places meet those who might also mesh well with others and who might build people up to their potential.   

So, dream big and bring others along the journey.  Find a passion and a motivation!